Payer Operations Leadership Specialist
4 days ago
Payscale Estimate: $160,000 - $220,000 per year
Job Description:About the RoleWe are seeking an experienced Payer Utilization Management Consulting Leader to join our team at Accenture. As a trusted advisor to clients, you will help them address utilization management challenges and develop effective strategies to improve efficiency, compliance, and member experience.
Key responsibilities include leading client engagements, overseeing multiple projects simultaneously, and managing cross-functional teams to deliver high-quality results on time and within budget.
You will also develop and implement best practices for utilization management, including prior authorization, case management, and appeals processes.
In addition, you will facilitate workshops, presentations, and working sessions with clients and stakeholders, staying current with healthcare industry trends, regulatory changes, and emerging technologies related to payer utilization functions.
What We're Looking For- Bachelor's degree in Business Administration, Healthcare Management, Health Policy, or a related field.
- Minimum of 5 years of experience in payer utilization management, health administration, healthcare consulting, or payer operations with a focus on utilization management.
- Minimum of 5 years of experience in healthcare regulations and accreditation requirements.
- Preferred qualifications include a Master's degree, experience working with or leading global teams, and leadership experience executing and achieving specific health utilization and medical cost outcome metrics.
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